Quality Blue Program

Program Location: 
Baton Rouge, LA
Payer Type: 
Commercial
Payers: 
Blue Cross and Blue Shield of Louisiana
Description: 

Quality Blue Primary Care (QBPC) is Blue Cross and Blue Shield of Louisiana's innovative population health and quality improvement program. QBPC is designed to get better outcomes for patients with chronic diseases, support doctors and transform healthcare delivery. To implement QBPC, Blue Cross and Blue Shield of Louisiana is targeting primary care physicians in the network family medicine, internal medicine or general practice that have high volumes of patients who are Blue Cross members with one or more chronic conditions.  Quality Blue, which incorporates the standards of the nationally recognized Bridges to Excellence (BTE) program, offers financial incentives to physicians who achieve certified recognition of quality in diabetes care and cardiac care, as well as smart office practices in primary care that produce better outcomes for patients.

QBPC builds on the basic features of Patient-Centered Medical Home to offer an enhanced model for population health, in which providers can focus on improving care quality for their total patient population, not just those who are actively seeking treatment. Blue Cross will offer QBPC practices the technical and clinical support and guidance they need to manage their patients' care in the least disruptive way. The QBPC payment structure rewards providers for better patient outcomes, with a care management fee paid on top of their usual fee-for-service setup.

Payment Model: 

The QBPC payment structure rewards providers for better patient outcomes, with a care management fee paid on top of their usual fee-for-service setup. Incentive programs have been created to reward practices for becoming Patient-Centered Medical Home recognized. Blue Cross Blue Shield of Louisiana launched the Quality Blue Program to identify and reward physicians and healthcare providers who deliver high-value quality care that meets national standards of excellence. Quality Blue, which incorporates the standards of the nationally recognized Bridges to Excellence (BTE) program, offers financial incentives to physicians who achieve certified recognition of quality in diabetes care and cardiac care, as well as smart office practices in primary care that produce better outcomes for patients. For more information on the payment structure, see the QBPC policy manual

Improved Health: 

In the 2017 program year, providers enrolled in Quality Blue have made significant improvements in managing the chronic conditions that are the focus of the program, with percentages of patients who are successfully staying on top of their health conditions increasing to:

  • 34 percent for Diabetes Care
  • 71 percent for High Blood Pressure Care
  • 40 percent for Heart Disease Care
  • 76 percent for Kidney Disease Care
Cost Savings: 

12 network ACOs that were enrolled in the program during 2017 saved an average 4.26 percent on their total costs of healthcare, with the most successful savings reaching 12.21 percent.

Last updated Marzo 2019
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